TY - JOUR
T1 - Survival improvement of patients with FLT3 mutated acute myeloid leukemia :
T2 - results from a prospective 9 years cohort
AU - Oñate, Guadalupe
AU - Pratcorona, Marta
AU - Garrido, Ana
AU - Artigas-Baleri, Alícia
AU - Bataller, Alex
AU - Tormo, Mar
AU - Arnan, Montserrat
AU - Vives Polo, Susana
AU - Coll, Rosa
AU - Salamero, Olga
AU - Vall-Llovera, Ferran
AU - Sampol, Antonia
AU - Garcia, Antoni
AU - Cervera, Marta
AU - Garcia-Avila, Sara
AU - Bargay, Joan
AU - Ortín, Xavier
AU - Nomdedeu, Josep
AU - Esteve Reyner, Jordi
AU - Sierra, Jorge
PY - 2023
Y1 - 2023
N2 - Midostaurin added to intensive chemotherapy is the standard of care for acute myeloid leukemia (AML) with FLT3 mutations (FLT3 mut). We analyzed the impact of midostaurin in 227 FLT3 mut-AML patients included in the AML-12 prospective trial for fit patients ≤70 years (#NCT04687098). Patients were divided into an early (2012-2015) and late (2016-2020) cohorts. They were uniformly treated except for the addition of midostaurin in 71% of late group patients. No differences were observed in response rates or the number of allotransplants between groups. Outcome was improved in the late period: 2-year relapse incidence decreased from 42% vs 29% in early vs late group (p = 0.024) and 2-year overall survival (OS) improved from 47% vs 61% (p = 0.042), respectively. The effect of midostaurin was evident in NPM1 mut patients (n = 151), with 2-yr OS of 72% (exposed) vs 50% (naive) patients (p = 0.011) and mitigated FLT3 -ITD allelic ratio prognostic value: 2-yr OS with midostaurin was 85% and 58% in low and high ratio patients (p = 0.049) vs 67% and 39% in naive patients (p = 0.005). In the wild-type NPM1 subset (n = 75), we did not observe significant differences between both study periods. In conclusion, this study highlights the improved outcome of FLT3 mut AML fit patients with the incorporation of midostaurin.
AB - Midostaurin added to intensive chemotherapy is the standard of care for acute myeloid leukemia (AML) with FLT3 mutations (FLT3 mut). We analyzed the impact of midostaurin in 227 FLT3 mut-AML patients included in the AML-12 prospective trial for fit patients ≤70 years (#NCT04687098). Patients were divided into an early (2012-2015) and late (2016-2020) cohorts. They were uniformly treated except for the addition of midostaurin in 71% of late group patients. No differences were observed in response rates or the number of allotransplants between groups. Outcome was improved in the late period: 2-year relapse incidence decreased from 42% vs 29% in early vs late group (p = 0.024) and 2-year overall survival (OS) improved from 47% vs 61% (p = 0.042), respectively. The effect of midostaurin was evident in NPM1 mut patients (n = 151), with 2-yr OS of 72% (exposed) vs 50% (naive) patients (p = 0.011) and mitigated FLT3 -ITD allelic ratio prognostic value: 2-yr OS with midostaurin was 85% and 58% in low and high ratio patients (p = 0.049) vs 67% and 39% in naive patients (p = 0.005). In the wild-type NPM1 subset (n = 75), we did not observe significant differences between both study periods. In conclusion, this study highlights the improved outcome of FLT3 mut AML fit patients with the incorporation of midostaurin.
KW - Acute myeloid leukaemia
KW - Translational research
U2 - 10.1038/s41408-023-00839-1
DO - 10.1038/s41408-023-00839-1
M3 - Article
C2 - 37147301
SN - 2044-5385
VL - 13
JO - Blood Cancer Journal
JF - Blood Cancer Journal
ER -